Last Day of Intern Year

Before we took off for Chile (post soon!) we celebrated the end of intern year. The last 12, or really 18 months (from when Urology match happened) has been an absolute whirlwind. How we got here was something of a mix of luck and grit on Alex’s part. But we finally feel like we’re settled. And the dreaded surgical intern year? The one where people tell you it will be the worst year of your life? Or that your marriage might not survive? Well, maybe it used to be that way. Or maybe we were lucky-but it wasn’t nearly that bad. It wasn’t easy, and it involved a lot of flexibility and patience, but it never broke us. And I wanted to take a moment to write down how this year really was for us, before time wipes most of the memories clean.

The surgical look. It’s very fashionable.

Backing up a bit, Alex ended up starting his career as a prelim general surgery resident at Vanderbilt, where he matched after a somewhat fluke encounter where someone he was working with in NYC suggested it. So after finishing med school we moved back to the states to Nashville to begin this journey. I didn’t know what to expect. I’d heard horror stories and read blogs about how to survive surgical residencies. During one of his sub-internships at Cleveland Clinic he was late home, again, and exhausted. And I panicked. I worried our lives were about to be on pause for 5-6 years. That I’d never see him and when I did he’d be too tired to function. We aren’t one of those couples that seems to work not seeing much of each other. We went to Asia for three months, and never got sick of one another. We love our time together, and don’t tire of it. So I was deeply afraid our relationship was about to die on some level.

Vanderbilt, however, proved this to be a false worry. Not all programs are this caring, but the surgical department there actually cares about their interns (and prelims) and doesn’t treat them unfairly. It was hard, yes. I did see him a lot less than in med school (we were spoiled by the Irish system with more time flexibility and independent work). But, it wasn’t all that bad. It helped I chose not to work while we were in this flux year, as recommended by pretty much everyone we talked to. I took on the part time job of making sure our lives stayed together (while training for a marathon, my other part time hobby). And when his off day was Wednesday? We could hop in the car and explore. We protected his time off. I did 99% of the housework/errands/life maintenance. And joyfully. It meant that our time together was just our time, to relax, have fun, enjoy being together. I also had running and my own friends for when he inevitably worked long hours or overnight. It was a great balance. Would I want our lives to look like this forever? No. Or rather PLEASE NO. Was it the apocalypse? Certainly not. We worked together, and as a team navigated those first six months, knowing it wasn’t forever (our relationship on the other hand, we hoped to keep going a long, long time).

The hardest part of that first half of the year was not knowing where we’d end up. Alex firmly decided he wanted to be a Urologist. He knew he’d have job satisfaction (a rarity in surgery and medicine), and a life (also a rarity). But Urology is currently the most competitive speciality, and we had no assurances he would match into it. And that was hard. He didn’t want to do anything else, what would happen if he didn’t match? Would he go through life moderately dissatisfied? Luckily, we never found out. Stanford had an intern drop, they contacted Alex for an interview, and a few months later we were moving back to California. Alex worked incredibly hard and was an excellent candidate, so while it doesn’t surprise me, it was still a huge relief. He would get to pursue his passion, at a top-tier program, in our favorite place on earth. How was that even possible?! And I think this joy over how well things worked out helped us through the rest of intern year with a department that wasn’t malignant, but certainly was a far cry from Vanderbilt. But we knew it was only 6-months and he’d be onto Urology. We’ve found chunking time to be very effective. Just like running a marathon, where you only think about the mile, or segment, you’re currently in, we do the same in residency. There’s no point thinking  about how long there is to go, or what might happen. It’s wasted energy. Instead, we stay in months. This rotation. This week. It doesn’t always squash the fears, or slow the wanting to be done with residency, but it helps.

Stanford general surgery is more typical of surgical departments. Vanderbilt is special, programs don’t usually care as much as they did (though, they certainly should). It also isn’t a terrible program, so we were lucky in that way. But some of the things we were shielded from at Vanderbilt did impact us here. The culture was just less supportive. There was that old-school feeling like you should just “shut up, keep your head down, and take abuses.” Very old-boys club of Surgery. If you went over hours at Vanderbilt it was unacceptable. Here it was too, but only because they think you should have lied and adjusted your hours. The only time I agree with that is if you electively stayed on. But other than that? No. And a lot of interns do follow that unspoken word. Though the hours weren’t usually horrendous, Stanford was significantly harder, and not in ways that I think will make their residents any better for it. But again, not every rotation was bad, and before we knew it, it was over. I never once was mad at Alex for late nights or him being too tired. But I did admittedly become very angry at Stanford on a few occasions. I think it’s totally unacceptable how your quality of life is impacted because your chief is an asshole dead-set on not recognizing you’re a human with basic rights. It was a rare occurrence, but it did happen. And at the celebration dinner at the end of the year one chief noted that they did in fact care about their interns, even if it didn’t seem like it at times. Anxious laughter ensued. I don’t care if that’s “how it’s done.” Tradition is a poor excuse for continuing anything, and just because you were treated unfairly, it doesn’t give you the right to be terrible to someone else. Please check your ego. It’s absurd we feel lucky this only happened a handful of times. We are, however thankful people finally came to their senses and the years of 120 hour work weeks are long gone.

But this is what’s great about Urology. And why were excited, even though the next two years are going to be very busy. Urologists, across the board are kind people. Everyone in the hospital loves Urologists. There are of course, exceptions. But generally speaking they completely avoid the negative stereotypes of surgeons (which boasts a 20% residency attrition rate, as if this would shock anyone). And it’s been true for all the Urologists we’ve met so far. And while intern year was not exactly our favorite it overall was very manageable, and most importantly resulted in Alex gaining his spot as a Urologist. So, it was worth every sacrifice. So, goodbye general surgery, we are in no way sad to see you go. While we know we’re far from being “out of the woods” in terms of long days/tired residents we’ve made it one step closer. And we honestly feel like we’re not only surviving, but thriving. Here’s to another year navigating this bizarre world of medicine.